Department of Surgery, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
Endocr Pract. 2011 Sep-Oct;17(5):e130-4. doi: 10.4158/EP11183.CR.
To report a case of a retroperitoneal cystic teratoma that obscured and compressed the adrenal gland, mimicking a primary adrenal tumor.
The presenting manifestations, radiographic characteristics, gross and microscopic pathologic features, and results of surgical therapy and long-term follow-up are described.
A 50-year-old African American woman with a 2-year history of low back pain and night sweats had a computed tomographic scan of the abdomen, which revealed an incidental 8 by 4 by 3.5-cm left adrenal mass without a clear plane between the mass and the left crus of the diaphragm. Laboratory studies excluded a functioning adrenal tumor. The tumor was resected laparoscopically. It was compressing but not involving the adrenal gland, nor was it involving the diaphragm. Microscopic evaluation revealed a benign mature cystic teratoma characterized by cystic spaces lined by respiratory epithelium with cartilage, bone, lymphoid tissue, smooth muscle, and ganglionic tissue in the cyst wall. The patient had an uneventful postoperative course and is free of recurrence after 18 months of follow-up.
Although rare, a mature cystic teratoma of the retroperitoneum that compresses the normal adrenal gland may masquerade as a primary adrenal tumor and should be included in the differential diagnosis of a nonfunctioning adrenal incidentaloma.
报告一例腹膜后囊性畸胎瘤，该肿瘤掩盖并压迫肾上腺，类似于原发性肾上腺肿瘤。
描述了该病例的临床表现、影像学特征、大体和显微镜下病理特征，以及手术治疗和长期随访的结果。
一名 50 岁的非裔美国女性，有 2 年的腰痛和夜间出汗病史，行腹部计算机断层扫描，显示左侧肾上腺有一个 8×4×3.5cm 的偶然发现的肿块，肿块与左膈肌的交界面不清晰。实验室研究排除了功能性肾上腺肿瘤。肿瘤经腹腔镜切除。肿瘤虽有压迫，但未累及肾上腺，也未累及膈肌。显微镜评估显示为良性成熟囊性畸胎瘤，特征为囊性空间衬有呼吸上皮，囊壁内有软骨、骨、淋巴组织、平滑肌和神经节组织。患者术后无并发症，18 个月随访后无复发。
腹膜后成熟囊性畸胎瘤虽罕见，但可压迫正常肾上腺，使其类似于原发性肾上腺肿瘤，应纳入无功能肾上腺意外瘤的鉴别诊断。
